Journal of Human Lactation

Full-term newborn normative weight loss and factors influencing this were determined through chart audits (n = 812) at 6 hospitals in Manitoba, Canada. The effects of parity, gestational age, birth weight, sex, length of stay, type of delivery (cesarean vs vaginal), epidural use, and type of infant feeding (exclusively breastfed, partially breastfed, exclusively formula-fed) on percentage weight loss in hospital were analyzed using multiple regression analysis. In-hospital weight loss was 5.09% ± 2.89% (95% CI, 4.89-5.29), varying by feeding category: exclusively breastfed 5.49% ± 2.60% (95% CI, 5.23-5.74), partially breastfed 5.52% ± 3.02% (95% CI, 5.16-5.88), and formula-fed 2.43% ± 2.12% (95% CI, 2.02-2.85). Factors significantly increasing the percentage weight loss included higher birth weight, female sex, epidural use, and longer hospital stay. Lower percentage weight loss was associated with greater gestational age and exclusive formula feeding. Parity and type of delivery were not significant. Controlling for demographic and delivery-related variables, exclusive formula feeding had the largest impact, with 3.1% less weight loss than exclusive breastfeeding. J Hum Lact. 23(3):233-241.

The purpose of this descriptive, cross-sectional study was to assess adherence to the Baby-friendly Hospital Initiative “Ten Steps to Successful Breastfeeding” in certified hospitals in Brazil in 2002. The Ministry of Health ordered that all 172 hospitals certified from 1992 to 2000 be reassessed. Of the 167 eligible Baby-friendly Hospitals assessed, 137 (82%) met all of the 10 steps. Steps 2 and 3 presented the lowest adherence rates (91% and 92%, respectively), followed by steps 4, 5, and 10, with 95% each. Steps 7 and 9 reflected the highest adherence rate of 99% among all eligible Baby-friendly Hospitals. These findings suggest the need to intensify regular health training programs for professionals working in Baby-friendly Hospitals on managing and promoting breastfeeding and to implement strategies that favor steps 3 and 10, to further promote and support breastfeeding before and after delivery. J Hum Lact. 23(3):246-252.

Banked human milk, processed using low-temperature/long-time or Holder pasteurization, inactivates pathogenic microorganisms but degrades important biochemical components. High-pressure processing kinetics favor inactivation of microorganisms with retention of biochemical activity and nutritional quality of foods. The effects of high-pressure processing (400 MPa) and low-temperature/long-time pasteurization (62.5°C, 30 minutes) on total immunoglobulin A and lysozyme activity in human milk were investigated. Indirect modified enzyme-linked immunosorbent and a Micrococcus lysodeikticus turbidimetric assay were performed to measure immunoglobulin A immunoactivity and lysozyme activity, respectively. Pressure-treated samples retained significantly higher (P < .05) levels of immunoglobulin A and lysozyme activity compared to samples treated with low-temperature/ long-time pasteurization. These data suggest that high-pressure processing is a potential alternative to thermal pasteurization of human milk that can give greater retention of some bioactive components. Further research is needed to determine whether high-pressure processing can inactivate pathogens of concern in donor human milk. J Hum Lact. 23(3):253-261.

The Breastfeeding Initiative program is a collaboration between the Michigan Department of Community Health (Women, Infants, and Children Division) and Michigan State University Extension. It aims to increase breastfeeding rates among low-income women through the use of peer counselors. The study's purpose was to identify the program's strengths, operation procedures, and improvement areas from participants' and peer counselors' perspectives. Six focus groups were conducted: 3 of peer counselors and 3 of program participants. Findings revealed that peer counselors and participants were satisfied with the quality of services due to emotional and practical assistance and breast pumps provided by peer counselors. Peer counselors' job satisfaction was explained positively by the intrinsic rewards of helping others and negatively by perceived inadequate resources and recognition. Operating procedures varied greatly. Possible improvements include expanding services, providing peer counselors with additional support, and standardizing peer counselor operating procedures. The peer counselor model can effectively support low-income breastfeeding women. J Hum Lact. 23(3):262-268.

The present study evaluated the breastfeeding practice of 278 preterm infants born at the University Hospital of Londrina, Paraná, Brazil, during hospitalization and in the first 6 months of life. Data were obtained from the hospital records, and the mothers were interviewed by home visit (75.5%) or by telephone (24.5%) when the children were 6 months old. Data were analyzed statistically using the Kaplan-Meier survival method and Cox's multivariate regression model. During hospitalization, 100% of the preterm infants received human milk and 31% received exclusive breastfeeding. The median duration of exclusive breastfeeding and breastfeeding was 63.5 and > 180 days, respectively. The prevalence of breastfeeding in the sixth month was 54.7%, and 6.8% of the infants were still exclusively breastfed. Pacifiers were used (currently using or ever used) by 127 (45.7%) preterm infants and were associated with a 1.67 times higher risk of interruption of exclusive breastfeeding. J Hum Lact. 23(3):269-274.

The Internet has become an important tool for patients seeking to expand their knowledge of health conditions and medications. Breastfeeding initiation and duration increase because of physician encouragement. Therefore, electronic communication potentially provides additional opportunities for physicians to inform, reassure, encourage, and support breastfeeding families. An e-mail from a breastfeeding mother may deal with a topic well-suited to e-mail communication, such as information on the safety of specific medications during breastfeeding, or may deal with a concern that would make observation of breastfeeding necessary. Physicians have expressed qualms about electronic communication with patients due to privacy, malpractice liability, time, and reimbursement issues. Strategies to optimize e-mail communication include establishing a turnaround time for responses, informing patients of privacy issues, establishing what types of messages are appropriate over e-mail, and setting limits for when an e-mailed concern escalates to a need for an office visit. J Hum Lact. 23(3):275-279.